HASTALARIN PERİODONTAL KEMİK KAYBI VE TEDAVİ İHTİYACININ COVID-19'A GÖRE DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışma, hastaların periodontal kemik kaybı ve tedavi ihtiyaçlarını COVID-19'a göre değerlendirmeyi ve COVID-19 ile periodontal hastalık arasında bir ilişki olup olmadığını belirlemeyi amaçladı. Yöntem: Bu kesitsel çalışmaya Nisan 2021 ile Temmuz 2021 tarihleri arasında periodontoloji bölümüne tedavi için başvuran hastalar dahil edildi. Hastaların kişisel sağlık kaydı sistemine göre, pozitif bir polimeraz zincir reaksiyonu (PCR) testi pozitif COVID-19 hikayesi [COVID(+)] olarak tanımlanırken, kayıtlarda pozitif PCR olmaması negatif hikaye [COVID(-)] olarak tanımlandı. Periodontal tedavi ihtiyacı, Toplum Periodontal Tedavi İhtiyacı İndeksi ile değerlendirildi. Ayrıca dijital panoramik radyograflardan Progresif Hız İndeksi'ne (PRI) göre periodontal kemik kaybı (PBL) ölçüldü. Bulgular: Çalışma 138 hasta [COVID(+) 73, COVID(-) 65] ile yürütüldü. COVID(+) ve COVID(-) arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı bir farklılık tespit edilmedi. COVID(-)'de sigara içenlerin sayısı COVID(+)'den önemli ölçüde yüksekti (p: 0.045). PRI ve PBL varlığı açısından gruplar arasında anlamlı farklılık bulunmadı. COVID(+), COVID(-)'den daha yüksek skor 0, 1, 3 ve 4 yüzdesine sahipken; COVID(-) daha yüksek skor 2 yüzdesine sahipti (p< 0.000). Ancak, ortalama CPITN skorunun gruplar arasında anlamlı farklılık göstermediği bulundu. Sonuç: Bu çalışma, COVID-19 ile periodontal hastalık arasındaki ilişkiye dair bir eğilim olmadığını ortaya koymuştur. Hastanede yatan hasta sayısının arttırıldığı ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• COVID-19
• Periodontal Hastalık
• Periodontal Kemik Kaybı
• CPITN

EVALUATION OF PERIODONTAL BONE LOSS AND TREATMENT NEEDS OF PATIENTS ACCORDING TO THE COVID-19

Öz

Objective: This study aimed to evaluate patients' periodontal bone loss and treatment needs according to the COVID-19 and determine whether there is a relationship between COVID-19 and periodontal disease. Method: This cross-sectional study included patients admitted to the periodontology department for treatment between April 2021 and July 2021. According to the personal health system records of the patients, a positive real-time polymerase chain reaction (PCR) test indicated a positive COVID-19 history [COVID(+)], whereas no positive PCR in the records was defined as a negative history [COVID(-)]. Periodontal treatment need was assessed by the Community Periodontal Index of Treatment Needs (CPITN). In addition, periodontal bone loss (PBL) was measured from the digital panoramic radiographs according to the Progressive Rate Index (PRI). Results: The study was conducted with 138 patients [COVID(+) 73, COVID(-) 65]. There was no statistically significant difference between COVID(+) and COVID(-) in terms of age and sex. The number of smokers in COVID(-) was significantly higher than COVID(+) (p: 0.045). No significant difference was found between the groups regarding the PRI and the presence of PBL. While COVID(+) had a greater percentage of score 0, 1, 3, and 4 than COVID(-); COVID(-) had a higher percentage of score 2 (p<0.000). However, it was found that the mean CPITN score did not differ significantly between the groups. Conclusion: This study revealed that there is no trend regarding the association between COVID-19 and periodontal disease. Future studies with more hospitalized patients are needed.

Anahtar Kelimeler

• COVID-19
• Periodontal Disease
• Periodontal Bone Loss
• CPITN

Kaynakça

1. Struyf T, Deeks JJ, Dinnes J, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19. Cochrane Database Syst Rev. 2021;2:Cd013665.
2. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513.
3. Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. J Clin Invest. 2020;130(5):2202-2205.
4. Pan W, Wang Q, Chen Q. The cytokine network involved in the host immune response to periodontitis. Int J Oral Sci. 2019;11(3):30.
5. Genco RJ, Sanz M. Clinical and public health implications of periodontal and systemic diseases: An overview. Periodontol 2000. 2020;83(1):7-13.
6. Pitones-Rubio V, Chávez-Cortez E, Hurtado-Camarena A, González-Rascón A, Serafín-Higuera N. Is periodontal disease a risk factor for severe COVID-19 illness? Med Hypotheses. 2020;144:109969.
7. Scannapieco FA. Role of oral bacteria in respiratory infection. J Periodontol. 1999;70(7):793-802. Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12(1):8.
8. Marouf N, Cai W, Said KN, et al. Association between periodontitis and severity of COVID-19 infection: A case-control study. J Clin Periodontol. 2021;48(4):483-491.

9. Sirin DA, Ozcelik F. The relationship between COVID-19 and the dental damage stage determined by radiological examination. Oral Radiol. 2021;37(4):600-609.
10. Larvin H, Wilmott S, Wu J, Kang J. The impact of periodontal disease on hospital admission and mortality during COVID-19 pandemic. Front Med (Lausanne). 2020;7:604980.
11. Anand PS, Jadhav P, Kamath KP, Kumar SR, Vijayalaxmi S, Anil S. A case-control study on the association between periodontitis and coronavirus disease (COVID-19). J Periodontol. 2022;93(4):584-590.
12. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama. 2013;310(20):2191-2194.
13. Ainamo J, Barmes D, Beagrie G, Cutress T, Martin J, Sardo-Infirri J. Development of the World Health Organization (WHO) community periodontal index of treatment needs (CPITN). Int Dent J. 1982;32(3):281-291.
14. Beckstrom BW, Horsley SH, Scheetz JP, et al. Correlation between carotid area calcifications and periodontitis: a retrospective study of digital panoramic radiographic findings in pretreatment cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(3):359-366.
15. Sampson V, Kamona N, Sampson A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections? Br Dent J. 2020;228(12):971-975.
16. Takahashi Y, Watanabe N, Kamio N, Kobayashi R, Iinuma T, Imai K. Aspiration of periodontopathic bacteria due to poor oral hygiene potentially contributes to the aggravation of COVID-19. J Oral Sci. 2020;63(1):1-3.
17. Kara C, Çelen K, Dede F, Gökmenoğlu C, Kara NB. Is periodontal disease a risk factor for developing severe Covid-19 infection? The potential role of Galectin-3. Exp Biol Med (Maywood). 2020;245(16):1425-1427.
18. Sampson V. Oral hygiene risk factor. Br Dent J. 2020;228(8):569.
19. Leung JM, Yang CX, Tam A, et al. ACE-2 expression in the small airway epithelia of smokers and COPD patients: implications for COVID-19. Eur Respir J. 2020;55(5):2000688.
20. Paleiron N, Mayet A, Marbac V, et al. Impact of Tobacco Smoking on the Risk of COVID-19: A Large Scale Retrospective Cohort Study. Nicotine Tob Res. 2021;23(8):1398-1404.
21. Lippi G, Henry BM. Active smoking is not associated with severity of coronavirus disease 2019 (COVID-19). Eur J Intern Med. 2020;75:107-108.
22. Lippi G, Sanchis-Gomar F, Henry BM. Active smoking and COVID-19: a double-edged sword. Eur J Intern Med. 2020;77:123-124.
23. Larvin H, Wilmott S, Kang J, Aggarwal VR, Pavitt S, Wu J. Additive Effect of Periodontal Disease and Obesity on COVID-19 Outcomes. J Dent Res. 2021;100(11):1228-1235.
24. Jiang Y, Zhou X, Cheng L, Li M. The Impact of Smoking on Subgingival Microflora: From Periodontal Health to Disease. Front Microbiol. 2020;11:66.
25. Shinzato T, Saito A. A mechanism of pathogenicity of "Streptococcus milleri group" in pulmonary infection: synergy with an anaerobe. J Med Microbiol. 1994;40(2):118-123.